89 articles - From Friday Nov 11 2022 to Friday Nov 18 2022
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
meta-analyses and systematic reviews
| Gastrointest Endosc |
Early (<4 Weeks) Versus Standard (= 4 Weeks) Endoscopic Drainage of Pancreatic Walled-Off Fluid Collections: A Systematic Review and Meta-analysis. Both early (< 4 weeks) and standard (= 4 weeks) drainage of walled off pancreatic fluid collections offer similar technical and clinical outcomes. Patients requiring endoscopic drainage should not be delayed for 4 weeks. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial. With rapidly expanding medication choices for Crohn's disease and slow uptake of early intensive therapy, SDM can personalise treatment strategies and has the potential to move the field of Crohn's disease management forward with an ultimate goal of consistently treating this disease early and intensively in appropriate patients. |
Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding. Aspirin for primary cardiovascular prevention was rarely deprescribed at discharge in patients hospitalised with GIB. Processes designed to ensure appropriate deprescription of aspirin are crucial to improve adherence to guidelines, thereby improving the risk-benefit ratio in patients at high risk of subsequent GIB hospitalisations with minimal increased risk of MACE. |
Non-invasive monitoring and treat-to-target approach are cost-effective in patients with mild-moderate ulcerative colitis. T2T-FC approach resulted in a higher benefit for mild-moderate UC patients in terms of time in remission and incidence of relapse but was associated with higher costs. Clinical trials and real-world clinical studies are needed to provide additional data on the cost-benefit of this approach. |
Randomised clinical trial: efficacy and safety of the live biotherapeutic product MRx1234 in patients with irritable bowel syndrome. MRx1234 has the potential to become a novel, safe treatment option for patients with IBS-C or IBS-D, and for those who have mixed symptoms or transition between subtypes. #NCT03721107. |
The Liverpool alcohol-related liver disease algorithm identifies twice as many emergency admissions compared to standard methods when applied to Hospital Episode Statistics for England. The algorithm has revealed the true extent of ArLD admissions. The pandemic has compounded a long-term rise in ArLD admissions and mortality. |
| Am J Gastroenterol |
Patient-Reported Impact of Symptoms in Crohn's Disease. Patients with CD experience numerous symptoms that affect their daily life. These symptoms, some underrecognized, vary based on disease and demographic characteristics and represent potential targets for future therapeutic interventions. |
| Clin Gastroenterol Hepatol |
Abdominal Bloating in the US: Results of a Survey of 88,795 Americans Examining Prevalence and Healthcare Seeking. Women and those with certain comorbidities and concomitant GI symptoms are more likely to experience bloating and have more severe symptoms. Nearly one-third of sufferers that have not sought care are managing symptoms on their own or feel uncomfortable discussing it with their providers, emphasizing that efforts should be made to proactively inquire about bloating. |
ALT is not associated with achieving subcirrhotic liver stiffness and HCC during entecavir therapy in HBV-related cirrhosis. Baseline and on-treatment ALT levels were not associated with achieving subcirrhotic LS at 5 years of ETV, or risk of HCC development beyond 5 years of ETV in patients with HBV-related cirrhosis. Achieving subcirrhotic LS at 5 years of ETV was independently associated with lower risk of HCC development beyond 5 years of ETV. |
| Endoscopy |
Incomplete resection of 4 CSP for 4-9mm polyps is safe and feasible. However, for lesions =10mm, CSP failure occurs frequently, and IRR remains high even after technical success. Incomplete resection was associated with flat polyps, visual residual polyp, piecemeal resection, and difficult polypectomies. |
Prevalence of Synchronous Neoplasia in Patients with Large Pedunculated Colorectal Polyps. In patients with large (= 20 mm) pedunculated colorectal lesions, rates of synchronous neoplasia and advanced synchronous neoplasia are high and comparable to or higher than rates of synchronous neoplasia in patients with large (= 20 mm) nonpedunculated colorectal lesions. |
| J Hepatol |
Baveno VII algorithm outperformed other models in ruling out high-risk varices in individuals with HBV-related cirrhosis. We validated that the Baveno VII algorithm with SSM@50 Hz and SSM@100 Hz both exhibited excellent performance in ruling out HRV in patients with HBV-related cirrhosis. Furthermore, the Baveno VII algorithm with SSM@100 Hz could safely rule out more EDGs than that with SSM@50 Hz. Impact and implications The Baveno VII guideline proposed that for patients who do not meet the Baveno VI criteria, SSM =40 kPa could avoid further unnecessary endoscopy screening. The current study validated the Baveno VII algorithm using 50 Hz and 100 Hz probes both exhibited excellent performance in ruling out HRVs in patients with HBV-related cirrhosis. Compared with the Baveno VII algorithm with SSM@50 Hz, SSM@100 Hz had a better capability to safely rule out unnecessary EDGs. Baveno VII algorithm will be a practical tool to triage patients with cirrhosis in future clinical practice. Clinical trial number NCT04890730. |
Changes in abdominal adipose tissue depots accessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis. In adults with NASH in the FLINT trial, those with greater longitudinal reductions in dSAT and potentially VAT volumes showed greater hepatic histologic improvements, independent of reductions in hepatic PDFF. Impact and implications Although central obesity has been identified as a risk factor for obesity-related disorders including insulin resistance and cardiovascular disease, the role of central obesity in nonalcoholic steatohepatitis (NASH) needs further clarification. Our results highlight that reduction in central obesity, specifically deep subcutaneous adipose tissue and visceral adipose tissue, may be related to NASH histologic improvement. The findings from this analysis should increase awareness of the importance of lifestyle intervention in NASH for clinical researchers and clinicians. Future studies and clinical practice may design interventions that assess the reduction of deep subcutaneous adipose tissue and visceral adipose tissue as outcome measures, rather than simply weight reduction. Clinical trial number NCT01265498. |
Enhanced diagnosis of advanced fibrosis and cirrhosis in individuals with NAFLD using FibroScan-based Agile scores. The two novel non-invasive scores improve identification of cirrhosis or AF among liver clinics for NAFLD patients and reduce the need for liver biopsy in this population. Impact and implications Non-invasive tests currently used to identify patients with advanced fibrosis or cirrhosis, such as FIB-4 and Liver Stiffness Measurement by Vibration-Controlled Transient Elastography (LSM by VCTE) have high negative predictive values but high false positive results and often a large number of cases with indeterminate results. This study provides scores that will help the clinician diagnose advanced fibrosis or cirrhosis. Those new easy-to-implement scores will be tools to (1) help liver specialists better identify patients who need more intensive follow up, (2) to be referred for inclusion in treatment trials for those with NAFLD and either advanced fibrosis or cirrhosis, and (3) guide who should be treated with pharmacological agents when effective therapies are approved. |
Hepatocyte-specific Mas activation enhances lipophagy and fatty acid oxidation to protect against acetaminophen-induced hepatotoxicity in mice. The activation of Mas on hepatocytes enhanced AKT-FOXO1-dependent lipophagy and downstream FAO to protect mice from APAP-induced hepatotoxicity, suggesting that hepatocyte-specific Mas might be a novel therapeutic target for DILI. Impact and implications Mas signaling arises as a novel therapeutic target for patients with APAP overdose. Mas-AKT/FOXO1-fatty acid degradation pathway is critical for researchers to develop treatment strategies of APAP overdose. When Mas signaling is targeted, the extent of liver injury should be taken into account at the time of administration. These findings obtained from APAP-challenged mice still need to be confirmed in the clinics. |
Lysophosphatidylcholines modulate immunoregulatory checkpoints in peripheral monocytes and are associated with mortality in people with acute liver failure. Reduced amounts of LPCs are biomarkers of poor prognosis in patients with ALF. The LPC-ATX-LPA axis appears to modulate innate immune response in ALF via LPAR1 and LPAR3. Further investigations are required to identify novel therapeutic agents targeting these receptors. Impact and implications Liver disease is the 5 th leading cause of death in the UK and rising in incidence. Acute liver failure occurs on the background of normal liver function and mostly in young adults. Acute admissions to hospital and intensive care units are rising in the UK and worldwide. We identified a metabolic signature of acute liver failure and investigated the immunometabolic role of the Lysophosphatdylcholine(LPC)-Autotaxin (ATX)-Lysophosphatidylcholinic acid (LPA) pathway in order to find a mechanistic explanation for monocyte behaviour and find possible therapeutic target(s) to modulate the systemic immune response in ALF. At present, no selective immune based therapies exist. We were able to modulate monocyte phenotype and function in vitro and aim to extend findings to murine models of ALF before could apply this treatment to patients. Future therapies may be based on the enhancement of resolution through metabolic modulation and therefore the role of specific lipids in this pathway require elucidation and the relative merits of ATX inhibition, LPAR blockade or lipid-based therapies answered. This application aims to make a step change in meeting this knowledge gap and definitively elucidate these immune-metabolic pathways using an experimental medicine approach, thus finding the most effective therapeutic targets. |
| Neurogastroenterol Motil |
Corticotropin-releasing factor receptor agonists decrease interstitial cells of Cajal in murine colon. Chronic heterotypic stress (CHeS) was applied to mice to determine endogenous CRF-CRF receptor signaling on colonic ICC. Results We found that stressin1, a selective CRF receptor 1 (CRF to decrease the number and function of ICC, which provides a potential target for treating stress-induced gastrointestinal motility disorder. |
Dysregulated cystathionine-ß-synthase/hydrogen sulfide signaling promotes chronic stress-induced colonic hypermotility in rats. Background Hydrogen sulfide (H S signaling through increased MEK1 signaling might be important in the pathogenesis of chronic stress-induced colonic hypermotility. SAM could be administered for disorders associated with intestinal hypermotility. |
Impact of antegrade enema initiation on healthcare utilization in pediatric patients: A population-based cohort study. Understanding healthcare utilization patterns following antegrade enema initiation allows for effective health system planning and aids medical decision-making. The observed increase in ED visits for device-related complications speaks to the need to improve preventive management to help mitigate emergency care after initiation of antegrade enemas. |
Magnetic resonance imaging as a non-invasive tool to assess gastric emptying in mice. Our data indicate that MRI is a reliable and reproducible tool to assess gastric emptying in mice and represents a useful technique to study gastroparesis in disease models or for evaluation of pharmacological compounds. |
Pharyngeal biorhythms during oral milk challenge in high-risk infants: Do they predict chronic tube feeding? Robust pharyngeal rhythm may be an ideal neurosensorimotor biomarker of independent oral feeding. Differential maturation of cranial nerve-mediated excitatory and inhibitory components involving foregut, airway, and cardiac rhythms distinguishes the physiologic and pathophysiologic basis of swallowing and cardio-respiratory adaptation. |
Psychiatric comorbidities among adult patients with disorders of gut-brain interaction: Prevalence and relationships to treatment outcomes. Anxiety disorders are common among patients with DGBI and significantly reduce the likelihood of GI pharmacologic treatment response to any medication prescribed, including neuromodulators. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review: the safety of anticoagulants and antiplatelet agents in patients with cirrhosis. For both anticoagulants and antiplatelet agents, severe thrombocytopaenia presents a relative contraindication to their use. More prospective trials and large cohort studies are needed to advance our understanding of the safety and nuances of DOACs and antiplatelet agents in patients with advanced cirrhosis. |
| Gastrointest Endosc |
| Neurogastroenterol Motil |
Current and future perspectives on the utility of provocative tests of anal sphincter function: A state-of-the-art summary. In doing so, both provide information on the viscoelastic properties of the anal canal and offer new insights into its function. Purpose This review details the current and potential future applications of AAR and FLIP and highlights the unanswered questions relevant to these new technologies. |
Ten controversies IN gastroparesis and a look to the future. In addition, we briefly review studies exploring pathological, inflammatory, and molecular disturbances affecting the intrinsic neuromuscular elements that may be involved in the pathophysiology of gastroparesis and may constitute possible therapeutic targets in the future. Finally, we tabulate future research opportunities to resolve these controversies in the management of patients with gastroparesis. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Hepatology |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| J Hepatol |